… Objectives: To measure pulmonary artery and aortic calibers, and calculating main pulmonary artery to ascending aorta ratio in healthy children, to verify the adult ratio of 1:1. Study Design: Observational study. Place and duration of study: Radiology Department, Combined Military Hospital, Peshawar from 15 July 2015 to 14 July 2016. Methodology: Chest CT cans of 283 healthy children, with no history or predisposing causes of pulmonary hypertension, performed between July 2015 and July 2016, were retrospectively studied. Diameters of pulmonary artery and aorta were measured on CT chest, at the level of bifurcation of the main pulmonary artery, and the ratio of pulmonary artery to ascending aorta was calculated. Results: The average diameter of the main pulmonary artery, right pulmonary artery and left pulmonary artery were 19 mm, 12.1 mm and 12.2 mm respectively. The diameter of the ascending aorta was determined to be 12.2 mm and descending aorta was 13.67 mm. Ratio of the main pulmonary artery to ascending aorta was 1.06, which was higher than the adult ration, usually taken as <0.9. Conclusion: The measurement criteria devised for early detection of pulmonary hypertension have different set of values when considering pediatric population as compared to adults. Main pulmonary artery to ascending aorta ratio is significantly higher in healthy children of all ages as compared to adults. CT scan is an excellent minimally invasive modality in evaluation of the mediastinal vasculature.

Objective: To determine existing occurrences of motorcycle accidents, to identify the causes of accidents and to suggest measures to prevent these accidents from minimizing the undue loss of life and property. Study Design: Cross-sectional study. Place and Duration of Study: Emergency Departments of CMH Rawalpindi, CMH Lahore and CMH Kharian, from Aug 2018 to Jul 2019. Methodology: A total of 384 individuals, who underwent motorcycle accidents and reported to the Emergency Department, were included in the study. A pretested questionnaire was used for all the relevant information on demographic, social, motorcycle, and accident-related parameters. Results: The mean age of accident victims was 34.4 ± 10.92 years. Motorcyclists having 6-10 years of driving experience, riding daily between 11-20 km, were most commonly involved in accidents. 67.9% drivers had a motorcycle driving license, while most of them (65.8 %) were not wearing a helmet at the time of the accident. Wet road was the most common cause of accidents (35.6%). Collisions mainly occurred with another car (31.7%). The head (26.8%) was the most common injury site, followed by the back/abdomen (24.2%). Conclusion: Road traffic accidents place a significant economic burden, especially in a developing country like ours. Observance of safety precautions, strict adherence to traffic rules and regulations, and the Pakistan Highway Code knowledge are mandatory to avoid any possible accident. A national effort is required for the prevention of accidents to conserve human life and the financial resources of the country.

Objectives: To evaluate breast lesions with doppler ultrasound and calculated the diagnostic accuracy of resistive index as a predictor of malignancy, taking histopathology as gold standard. Study Design: Cross-sectional study. Setting: Radiology Department, CMH Multan. Period: December 2015 to May 2016. Material & Methods: 150 female patients, having age between 20 – 60 years, with palpable breast lumps were admitted in the study. Doppler ultrasound of the lesion was performed with emphasis on the vascularity and resistive index was formulated. Categorization as malignant or otherwise was declared as established by doppler ultrasound. Patients then underwent biopsy followed by histopathology. Correlation of doppler ultrasound and histopathological findings was done with calculation of diagnostic accuracy of doppler ultrasound, keeping histopathology as gold standard. Results: The mean of age was 40.23 ± 5.75 years. In 81 breast doppler ultrasound positive patients, 73 (True Positive) showed malignant lesions in breast while 08 (False Positive) did not have malignancy on biopsy. Among 69 Breast Doppler Ultrasound negative patients, 06 (False Negative) demonstrated malignancy on biopsy whereas 63 (True Negative) did not have any malignant lesion. Overall specificity was 88.77%, sensitivity 92.40%, negative predictive value 91.30%, positive predictive value 90.12% and diagnostic accuracy of Doppler Ultrasound came out 90.67%. Conclusion: Angiogenesis in malignant lesions lead to formation of structurally abnormal and tortuous vessels with increased resistive index. Doppler ultrasound is a safe and effective modality which shows acceptable diagnostic accuracy for noninvasive characterization of malignant breast lesions. Therefore, it can be employed as an alternative to histopathology in patients who present with breast lesions.

Objectives: To measure pulmonary artery and aortic calibers, and calculatingmain pulmonary artery to ascending aorta ratio in healthy children, to verify the adult ratio of1:1. Study Design: Observational study. Place and duration of study: Radiology Department,Combined Military Hospital, Peshawar from 15 July 2015 to 14 July 2016. Methodology:Chest CT cans of 283 healthy children, with no history or predisposing causes of pulmonaryhypertension, performed between July 2015 and July 2016, were retrospectively studied.Diameters of pulmonary artery and aorta were measured on CT chest, at the level of bifurcationof the main pulmonary artery, and the ratio of pulmonary artery to ascending aorta wascalculated. Results: The average diameter of the main pulmonary artery, right pulmonary arteryand left pulmonary artery were 19 mm, 12.1 mm and 12.2 mm respectively. The diameter of theascending aorta was determined to be 12.2 mm and descending aorta was 13.67 mm. Ratio ofthe main pulmonary artery to ascending aorta was 1.06, which was higher than the adult ration,usually taken as <0.9. Conclusion: The measurement criteria devised for early detection ofpulmonary hypertension have different set of values when considering pediatric population ascompared to adults. Main pulmonary artery to ascending aorta ratio is significantly higher inhealthy children of all ages as compared to adults. CT scan is an excellent minimally invasivemodality in evaluation of the mediastinal vasculature.

Objectives: To compare the diagnostic accuracy of transabdominal ultrasonography and contrast enhanced magnetic resonance imaging, in the differentiation of benign and malignant adnexal masses. Study Design: A prospective comparative study. Place and Duration of Study: Armed Forces Institute of Radiology and Imaging (AFIRI), Rawalpindi from 16 Jun 2015 to 15Jun 2016. Methodology: 61 female patients with adnexal masses, irrespective of age, were evaluated with transabdominal ultrasonography and contrast enhanced magnetic resonance imaging (MRI). This was followed by surgery (either laporotomy or laproscopy) or ultrasound guided biopsy and then histopathology to characterize them as benign or malignant masses. Results: Diagnostic accuracy of contrast enhanced MRI for characterization of adnexal masses was 90.1%, while that of transabdominal ultrasonography was 72.1 %. Sensitivity and specificity of transabdominal ultrasonography was 100 % and 54 % respectively while positive predictive value was 58.5 % and negative predictive value was 100 %. Sensitivity and specificity of MRI was 95.8 % and 86.4 % respectively while positive predictive value was 82.1% while negative predictive value was 96.9 %. Conclusion: Contrast enhanced MRI has a superior diagnostic accuracy as compared to transabdominal ultrasonography in the characterization of adnexal masses into benign and malignant, which influences the mode of treatment and clinical outcome.